cancer second opinion 1

How to Get a Cancer Second Opinion?

You just came back from your oncologist’s office. You’ve been diagnosed with cancer and you’re itching to start treatment right away to get rid of the tumor. If that is what is going through your mind, it is totally normal. The majority of people diagnosed with cancer have this reaction. But… I urge you not to rush and seek a cancer second opinion. See, despite what you hear and read, when you are diagnosed with cancer, you usually have enough time to do your research to make sure that your cancer diagnosis is correct. After all, you want to get the right treatment from the first time. Of course, there are some true medical emergencies that need to be treated immediately but those are uncommon. If your case is a true emergency, your cancer doctor will admit you to the hospital and start your treatment immediately. For all other situations, you have time. Unless you are already at a research cancer center, I highly recommend you get a cancer second opinion, if nothing else, at least to get the peace of mind.

You might be asking yourself why? The answer is simple: There are many treatment options for every stage of cancer. You want to make sure that the one you choose is the right one for you. A cancer second opinion can help you discuss other options or back up the option you already discussed with your oncologist. When you have a full understanding of your diagnosis and treatment options, you become more confident.

I understand you being nervous about getting a second opinion for cancer. We hear it all the time. Patients often feel that their doctor might be upset about seeking a cancer consultation with another oncologist. The reality though is that your oncologist will welcome the idea that you are exploring all options. Don’t let your nerves prevent you from seeking a cancer second opinion.  It can provide you and your family with reassurance and can ensure that you are proceeding with the best course of action for your treatment.

In this guide, I will make it as simple and detailed for you:

1- First, what is a Cancer Second Opinion?

As the name implies:

A second opinion is an independent review of your diagnosis and treatment recommendations. Click To Tweet

It involves the advice of another cancer doctor, or a team of doctors who specialize in your specific type of cancer. This multidisciplinary team may include surgeons, oncologists, pathologists, radiation therapists, and sub-specialist oncologists.

2- What will the new cancer doctor review?

The cancer consultation will review your case in detail focusing on the following:

  • The extent of the cancer or stage of the cancer.
  • The pathology report that describes how the cancer appears like under a microscope. If there is concern about the diagnosis, the second doctor might want to ask for some tests to be repeated to remove any doubt.
  • Your physical health. This is very important because your current overall state of health guides the type of treatments you can take. After all, the goal is to make you better not sicker with medicine that might be too intense for you.
  • Your proposed cancer treatment plan.

cancer second opinion doctor

The rest of the medical reports and test results are also reviewed in detail. After reviewing all of your information, the second opinion doctor can confirm your initial cancer diagnosis, including the type and stage of the cancer and what they think the best treatment is. Alternatively, they might change your diagnosis or treatment

cancer-survivor-blog

3- How a Second Opinion for Cancer can help you

After reviewing your records, a second opinion will provide you with the following information:

  • Confirmation of your diagnosis. If there is any doubt, you will be told that more tests are needed.
  • Additional details about your cancer. This includes details about its exact location, its stage and whether it has spread to other parts of the body.
  • The opinion of medical experts who specialize in your cancer. This cannot be overstated. Cancer treatment is changing every day and no oncologist can be up to date with all the new information. You want the opinion of a doctor who specializes mainly in your type of cancer and is familiar with the new available treatments.
  • Treatment options, including new or experimental treatments that may be available to you. The cancer second opinion might also suggest some clinical trials for you.

Even if a second opinion for cancer isn’t required by your insurance, I advise you to get a second opinion. The majority of the patients I talk to invariably say the same thing “I love my doctors but I want to make sure I am not missing on any option”. Getting your peace of mind alone is enough of a reason to seek a cancer second opinion.

After the diagnosis is confirmed, the cancer treatment second opinion may agree with the initial plan. In other cases, the second opinion might suggest other treatment options that you may not have considered, or even knew were available. Sometimes, an entirely different course of action to take may even be recommended. There are more treatment options than ever for all types of cancers.

4- Why getting a Second Opinion for Cancer is important

As much as we hate to admit it, medical errors happen. Click To Tweet

Getting another set of fresh eyes to review your file can detect a mistake or can confirm that you are getting the right cancer treatment. A cancer diagnosis is made with either a biopsy of the tumor and examination under the microscope or by blood tests. A pathologist usually reviews both and suggests a diagnosis after discussing with the oncologist. However, not all cancer diagnoses are easy to make. Some diagnoses are not correct.

As an example, researchers at The Johns Hopkins Hospital in Baltimore, Maryland reviewed tissue samples from 6,000 cancer patients, and they discovered that one out of every 71 cases was misdiagnosed. Additionally, one out of every five cancer cases was misclassified.

Given that an estimated 1.3 million people are diagnosed with cancer each year, and the findings on misdiagnosis and classification, getting a second opinion on a cancer diagnosis is not only important, but it can be life saving. In fact, many insurance companies require a second opinion before covering the cost of treatment.

5-When should you get a Second Opinion?

Ideally, every cancer patient should have another opinion before starting treatment Click To Tweet.

To make it more specific, I would suggest you get a second opinion if:

  • You want to confirm your cancer diagnosis.
  • You want to make sure you are getting the right cancer treatment.
  • The proposed treatment is toxic or risky.
  • You have been diagnosed with an uncommon, or rare form of cancer.
  • You reside in a rural area.
  • The proposed treatment is experimental.
  • You are not 100% confident with your current doctor’s ability to accurately diagnose your cancer.
  • You are not confident in your current doctor’s ability to treat your cancer.
  • Your current doctor has not treated many patients with your specific type of cancer.
  • You want to make sure that nothing was missed, overlooked, or misinterpreted.
  • Your cancer is not responding to the treatment you are currently receiving.
  • You want to learn more about clinical trials.
  • You want the opinion of multiple experts in your specific type of cancer.
  • Your doctor tells you that there aren’t any treatment options available to treat your cancer.
  • Your insurance company requires receiving a cancer second opinion before covering the cost of treatment.

In addition, a cancer second opinion may be called for to confirm the order of treatment if there are multiple procedures recommended in sequential order for your cancer. For instance, should you have chemotherapy first and radiation and then get surgery? Or, should you have surgery first then radiation then chemotherapy?

6- How to tell Your Doctor You’d Like a Cancer Second Opinion

Approaching the topic of getting a second opinion with your existing oncologist may seem daunting. You don’t want to undermine or hurt anyone’s feelings.  Remember though, you’re not being pushy or insulting by wanting a second opinion. You don’t have to be a passive receiver of health care services. As a patient, you can be the advocate for your own healthcare, and it is your right to get a second opinion.

If you want another opinion, but you’re apprehensive in discussing it with your doctor, take comfort in knowing that a second opinion is quite common among cancer patients.

Most doctors are at ease with the request for a cancer second opinion. They understand that you want to be as informed as possible, and want to ensure that you receive the best treatment. They also understand that your insurance provider may require a second opinion.

That said, if you are unsure how to approach the topic of getting a second opinion with your doctor, here are some of my suggestions to make the conversation easier for you.

Second Opinion Conversation Starters….

Try one of these conversation starters when approaching the topic of a second opinion with your doctor:

  • “If you were diagnosed with my type of cancer, would you get a second opinion?”
  • “I am thinking about getting a second opinion. What do you think?”
  • “Before we proceed with treatment, I would like to get a second opinion. Would you be able to help me with that?”
  • “My spouse wants me to get a second opinion.”

I assure you that when you are open and honest about your concerns, your doctor will have no problem with that. As a matter of fact, chances are that he will welcome the idea. 

7- How to Find a Doctor for a Second Opinion:

When getting a cancer second opinion,

your second doctor or team should be an independent expert about your cancer type. Click To Tweet

Here are some suggestions to help you find another doctor:

  • Ask trusted friends and family members who have been diagnosed with cancer to refer you to the doctor that treated them for a second opinion.
  • Ask your primary care physician or your current oncologist to refer you to an expert who specializes in your type of cancer. For example, if you have been diagnosed with breast cancer, ask your current doctor to refer you to a doctor who specializes in breast cancer.
  • Check with the hospitals in your area. They may have an oncologist referral service, which would be very useful for finding a doctor for a second opinion.
  • Check with an online service that provides expert second opinions for cancer online. At cancerdocs for example, university professors who specialize in particular cancers offer those opinions. If you want to learn more and discuss yoru case please contact us via chat, phone or email.

cancer second opinion oncologist

8- How to Prepare for the Cancer Second Opinion Appointment

You’ve finally decided that you would like to get a second opinion to confirm your diagnosis and ensure you are receiving the best treatment. Once you have found a doctor and made an appointment for your second opinion, you need to prepare for the appointment. Unlike your initial cancer diagnosis appointment, the second opinion appointment is different, and as such, needs to be prepared for differently.

To ensure that you get the most out of your second opinion appointment as possible, here are some suggestions to help you prepare for this appointment:

  • Make sure you bring all of your medical records with you. This typically  includes copies of diagnostic scans, exams, blood tests, pathology reports, hospital discharge summaries, genetic testing results, list of medications, current physician’s report, and any information about previous treatments that you have received. Gather all of this together well in advance of your second opinion appointment. Storing it in a clearly marked folder would be beneficial.
  • Make certain that you know what your goals are for your second opinion appointment. Are you looking for a confirmation of your diagnosis? Do you want to make sure that your current or recommended treatment options are the best? Are you interested in finding out if clinical trials for your specific type of cancer are available?
  • Know what questions you would like to ask. Write down any questions that you would like to have answered prior to your appointment so that you can ensure that they are all addressed.
  • Bring someone with you. Ask a trusted family member or friend to go along with you for your cancer second opinion appointment. Having two sets of ears is always better than one. Additionally, a friend or family member will be able to raise questions that you may have overlooked.

If you are requesting an online second opinion, the process will be much faster but you still need your records so that the doctor can give you his best advice.

9- What to Expect in the Second Opinion Process

Though the process of getting a second opinion varies from doctor to doctor, here is a look at what you can expect during the second opinion process.

 Checking with your insurance company to make sure they cover the cost of getting a second opinion. Many insurance companies do cover the cost, and many actually require a second opinion before they will cover any expenses related to treatment for cancer. It is crucial to understand the details of your insurance coverage regarding getting a second opinion so that you can be sure you are abiding by the policy. Find out what type of information is required by your insurance company, what your provider will cover, and how you should proceed with filing any insurance claims.

If you are seeking a second opinion regarding your treatment plan, generally, your pathology report will be included. However, there is the possibility of seeking out a pathology second opinion on your own. Check with your insurance company first, to make sure that they will cover the cost of a pathology second opinion.

 Gathering all of your medical records and test results. Depending on the doctor, you may have to have all of this information sent over before your second opinion appointment. Check with the physician well in advance of your appointment so that you are aware of how he or she expects your records and test results to be delivered.

 Making sure you fully understand the details of your second opinion, including the diagnosis and the treatment plan. Ask the second opinion doctor for detailed information, and ask for reports that highlight pertinent information.

cancer second opinion records

10- Is there Ever a Need for a Third Opinion?

If you have had a second opinion, you may be wondering if a third opinion is warranted.  If two doctors reach a consensus on your diagnosis and treatment, then it may not make sense to find a third doctor who will say essentially the same thing.

However, if your second opinion varies greatly from your first opinion, you may want to seek a third opinion. You want to be careful though not to waste too much time in making a decision. After all, you really want to get treatment. A third opinion however can ensure that an accurate diagnosis and treatment plan have been made.

Be aware, though, that receiving more than four opinions can lead to confusion and may not be beneficial, in the long run.

11- Making Sense of a Second Opinion

Your initial opinion can be overwhelming, and the second opinion can be even more so. It can be difficult to make sense of all of the information that you have received from your second opinion. This is particularly true when the second opinion differs greatly from the initial diagnosis and/or treatment plan, or when it completely contradicts it.

If you are facing a second opinion that varies greatly from, or completely contradicts your initial diagnosis and/or treatment plan, the following tips may be helpful:

  • Discuss your second opinion with the doctor who made your initial diagnosis. Your first doctor may be able to better explain the difference of opinion, or he or she may even agree with the second opinion.
  • Ask both doctors to explain how they drew their conclusions. Inquire about the studies or professional guidelines they used to make your treatment recommendations, and how they have advised other patients who have been diagnosed with the same type of cancer you have been diagnosed with.
  • Get a third opinion. The advice of another specialist, such as a pathologist, a surgeon, a medical oncologist or a radiation oncologist, may help you better understand your second opinion.

Never be afraid or apprehensive to ask for a second opinion. You’ll be able to start your treatment with confidence, knowing that you’re getting the best care possible.

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Michel completed his Oncology training at the University of California at San Diego and specialized in cancers of the kidneys, prostate and testicular cancer at the MD Anderson Cancer Center. With the constant changes in diagnostic tests and treatment options, he believes every patient should have access to the highest level of care.

About Michel Choueiri

Michel completed his Oncology training at the University of California at San Diego and specialized in cancers of the kidneys, prostate and testicular cancer at the MD Anderson Cancer Center. With the constant changes in diagnostic tests and treatment options, he believes every patient should have access to the highest level of care.

3 thoughts on “How to Get a Cancer Second Opinion?

  1. My cousin was recently diagnosed with cancer and has been trying to decide what to do next as far as treatment. You mentioned that a second opinion involves the advice of another doctor or a team of doctors who specialize in your specific type of cancer. Do most oncologists offer second opinions or have specific treatments that they prefer to use? It appears that going to see an oncologist could be helpful.

  2. Dear Derek,
    Thank you for your question. Oncologists indeed offer second opinions and suggest what they believe is the best option. However, while seeking a second opinion, you want to consult with an expert who specializes only in a particular type of cancer and has vast experience and uptodate knowledge about the latest treatment options.

  3. This post is really well written and explains the important benefits of getting a second opinion. Many people want to rush to get treatment but it is better for them if they get a second opinion first just to confirm that the diagnosis is correct and find out all the available treatment options for them so that the best one can be selected.

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